Active NPI
Charles J Dombrowski, D.M.D
- General Practice Dentistry
- Altoona, PA
National Provider Identifier
1982789236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DS024756L
- Practice address
- 100 Logan Blvd
Altoona, PA 16602-3115 - Phone
- (814) 944-7721
- Fax
- (814) 949-9044
- NPI assigned
- Oct 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DS024756L | PA | Primary |
Addresses
Primary practice location
100 Logan Blvd
Altoona, PA 16602-3115
Mailing address
100 Logan Blvd
Altoona, PA 16602-3115
Phone (814) 944-7721
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161109002116 | PA | Order and Referring Only - Oral Surgery | 7214240084 | |
| O20170105002369 | PA | DME Supplier - Oral Surgery - Dentist | 1254612245 | Practice locations: Altoona, PA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1982789236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 LOGAN BLVD",
"city": "ALTOONA",
"state": "PA",
"postal_code": "166023115",
"telephone_number": "814-944-7721",
"fax_number": "814-949-9044"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 LOGAN BLVD",
"city": "ALTOONA",
"state": "PA",
"postal_code": "166023115",
"telephone_number": "814-944-7721",
"fax_number": "814-949-9044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOMBROWSKI",
"first_name": "CHARLES",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "PA",
"license": "DS024756L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Altoona, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.